Environmental Tobacco Smoke (ETS) exposure in children is a major public health problem, with as many as 43% of U.S. children or more than 15 million children, who live in a household with a smoker. In more than 70% of homes with both adult smokers and children, smoking is allowed within the home. Childcare centers are an underutilized venue for child health promotion and have a potentially significant influence on parental smoking behavior. Given that nearly 60% of preschoolers currently receive non-parental care on a daily basis, the potential to reach a large number of children and parents is substantial. Training childcare center workers (CCCWs) to conduct brief tobacco interventions (Bl), which have been demonstrated as an effective tool for smoking cessation, will prepare them to more effectively influence parental tobacco use behavior. A pilot study to determine the potential utility and impact of Bl training in childcare centers is proposed, with a target population of 1) children and their parents/care givers and 2) CCCW staff. By using an existing Bl training, originally intended for non-healthcare professionals, the study will collect pilot and feasibility data in preparation for more extensive research to evaluate the efficacy of a brief intervention training of CCCWs in childcare centers in diverse regions of the country. Phase 1 will be a baseline survey of parents of children in childcare centers to determine prevalence and estimated level of ETS exposure of children; document parental knowledge, attitudes, and behaviors with regards to ETS and smoking; and identify children exposed to ETS to recruit for prospective study. Phase 2 will be a prospective longitudinal, randomized, controlled, pilot study to examine the impact of Bl training on: 1) children's ETS exposure as measured by salivary cotinine levels; 2) parental knowledge, attitudes and behaviors regarding ETS exposure and tobacco use; and 3) proportion of CCCWs who report intervening with parents to reduce children's ETS exposure. During Phase 3, results will be analyzed and disseminated through publication. ? ? ?
